Department of Neurology, Medical College Baroda, Gujarat, India.
Cephalalgia. 2010 Aug;30(8):975-82. doi: 10.1177/0333102409357642. Epub 2010 Mar 12.
Response to indomethacin is an essential feature for the diagnosis of both paroxysmal hemicrania (PH) and hemicrania continua (HC). Cluster headache (CH) is widely considered to be a disease unresponsive to indomethacin.
We report four patients with CH who responded to indomethacin. Two patients, who were refractory to the usual therapy for CH, fulfilled the criteria for chronic CH. Conversely, two patients had a history of episodic CH and showed response to both indomethacin and the usual therapy for CH.
We also reviewed the literature for the presence of indomethacin response in patients with CH. We noted a large number of cases labeled as CH by the authors which showed a response to indomethacin.
Many cases of definite or possible CH were wrongly labeled as PH because of patients' responding to indomethacin.
The response to indomethacin in patients with CH may not be as immediate as in other indomethacin-responsive headaches, and many patients may need larger doses.
对消炎痛的反应是阵发性头痛 (PH) 和持续性偏侧头痛 (HC) 诊断的一个基本特征。丛集性头痛 (CH) 通常被认为对消炎痛无反应。
我们报告了 4 例对消炎痛有反应的 CH 患者。其中 2 例对 CH 的常规治疗无效，符合慢性 CH 的标准。相反，2 例患者有发作性 CH 病史，对消炎痛和 CH 的常规治疗均有反应。
我们还回顾了文献中 CH 患者对消炎痛反应的情况。我们注意到，许多被作者标记为 CH 的病例对消炎痛有反应。
许多明确或可能的 CH 病例因患者对消炎痛的反应而被错误地标记为 PH。
CH 患者对消炎痛的反应可能不像其他对消炎痛有反应的头痛那样迅速，许多患者可能需要更大的剂量。
